From:  Mobile health interventions for perinatal and postpartum depression among asian americans: a scoping review

 Characteristics of included studies (n = 25).

CitationStudy typePerinatal stagePopulation focus/Asian subgroupPlaceTimeline of data collectionInterventionOutcome measuresOutcome summary (pull out the quotes)
[17]Retrospective studyPerinatal (broad)Mixed group (1.7% Asian American)United States2016–2023Telehealth/virtualEPDS, Generalized Anxiety Disorder scale (GAD-7)Perinatal intensive outpatient program provided with weekly therapy and medication management
Comparison of in-person and telehealth delivery during the COVID-19 pandemic
86.9% women diagnosed with depression, no difference between service settings (in-person vs. virtual)
Maternal-infant bonding only significantly improved with in-person treatment
[14]Review studyPostpartumAsian AmericanUnited States2018Mobile application (app)EPDS, PHQAcceptance and intention to use e-mental health interventions by Asian Americans are limited
Cultural beliefs against mental illness and seeking services
Cultural values such as “saving face” for mental illnesses. Supernatural and religious causes wrongful actions committed against one’s ancestors/God
Mental illness as a sign of weakness
Significant barriers to mental health service utilization-lack of English proficiency
Increased resistance towards seeking professional mental health services among Chinese American mothers with PPD
[18]Pilot studyPostpartumAsian (11.3%)United States2021–2023Mobile app; short message service (SMS)/text; telehealth/virtualEPDS, PHQ-8, Five Facets of Mindfulness Questionnaire, Emotion Regulation QuestionnairePD most common United States childbearing morbidities
Centre M high feasibility and acceptability
Reduced depressive symptoms from preintervention to the postpartum period
Normalizing mental health concerns and discussion, decreasing feelings of shame and isolation
Participants expressed a desire to receive this content on their phones via an app
Routine prenatal care delivery systems rarely focus on mental wellness and are not included in maternity care (absence of psychiatric nurse practitioners or psychologists)
[19]Scoping reviewPerinatal (broad)Chinese immigrantUnited States 2023SMS/text; telehealth/virtual; telephone/interactive voice response (IVR)EPDSCultural influence, use of social media apps on PD care among immigrant women
Social media apps are widely accepted to raise awareness of mental health information and means of communication with healthcare providers
[20]Qualitative studyPerinatal (broad)Chinese immigrant (n = 13)United States 2014Mobile app; SMS/text—Perinatal health information received through social media
Positive attitude toward using apps, text messaging during the perinatal period, “It’s good to spread mental health information through such social media apps”
Many women joined the mothers’ communication groups on WeChat to gain useful parenting tips or encouragement from other women
Language barrier, “Trouble telling the doctor about the changes in her mood during the perinatal period. So, it’d be hard for her doctor to understand her condition”
Expressed desire to have access to a range of options to learn about PD “Every person has her own preference. When she needs the information, you need to give them choices of how such information is conveyed... (otherwise) the health messages you send out would be disposed of as junk text messages or junk Email”
Participants preferred social media apps over text messaging
Accessibility to more information to follow, who to follow, when to view it, and greater anonymity
[21]Pilot studyAntenatal10.2% (Asian, Native Hawaiian, or Pacific Islander)United States2020–2021Mobile app (Healthy Moms App)PHQ-8 score ≥ 1013.1% screened positive for depression; 37.9% of those with positive screens were referred to behavioral health services
Language barriers among immigrant populations limited access to health care and related information (apps available only in English and Spanish)
Services for care coordination, patient education, and referrals were unavailable due to a language barrier
App provided support for those at the highest risk for PD and adverse social determinants of health
The app was widely used by publicly insured patients at a federally qualified health centre
[22]Cross-sectional studyPerinatal (Broad)Asian (14.5%)United States2020–2023—International Classification of Diseases, Tenth Revision recorded in the electronic health recordAsian women carried the lowest prevalence, with fewer than 1in10 women diagnosed with perinatal psychiatric illness (PPI)
Cultural norms of denying symptoms and reducing contact with healthcare providers made women less likely to report PPI, especially during the COVID-19 pandemic, when anti-Asian racism spiked
Barriers to adequate identification include mental health stigma, lack of culturally sensitive assessments of psychiatric symptoms (e.g., somatic symptom measures), and provider bias
[23]Retrospective cross-sectional studyAntenatalAsian (Chinese)
(n = 110,584)		China2021–2022Mobile appPHQ-9, GAD-7Early pregnancy is one of the significant predictors of antenatal depressive symptoms, with an increased risk of 78.99 times
High-level depressive symptoms were 3.4% in the first trimester, decreased to 1.5% in the second trimester, and further to 1.4% in the third trimester
Mild depressive symptoms were 10.9% in the first trimester, 6.2% in the second trimester, and slightly rising to 6.3% in the third trimester
Contributing factors: lower marital satisfaction, living with parents-in-law, experiencing negative life events, substance use such as drinking and smoking before and during pregnancy, self-employed businesswomen
[24]Protocol-randomised controlled trialPostpartumAsian (Japanese)
(n = 2,500)		Japan2019–2021Mobile app (Luna Luna Baby app)EPDS, Kessler Psychological Distress Scale, Somatic Symptom Scale-8 (SSS-8), ISI, Maternal Anxiety Scale for 4–5-month-old childrenA fully automated iCBT programme has the potential to be effective in preventing major depressive episodes among pregnant women
Acceptability, feasibility, appropriateness, fidelity, and satisfaction with the intervention, assessed via self-report surveys at 34 weeks of gestation and by time spent on modules
[25]Qualitative studyPDAsian (Indian)
(n = 16)		India2021Telephone/IVR—Use of local language (recorded information on IVR system used local dialect and colloquial terms)
Health promotion materials (episode on stress management, old folk song, helpline for emotional support, advice/counselling
The majority preferred face-to-face contact to phone-based contact, “The phone content was great, but I prefer sitting and talking my heart out to someone that I know”
[26]Systematic/meta-analysis reviewPostpartumDiverse Background
(n = 3,252)		Diverse geography2021Telehealth/virtualEPDS, PHQ-9, Beck Depression
Inventory, Kessler 10,
Depression, Anxiety and
Stress Scale 		Cognitive behavioral therapy (CBT) and telephone-based support were identified as particularly beneficial for treating PPD
Interventions like internet-based behavioral activation therapy did not demonstrate significant efficacy
[27]Prospective longitudinal cohort studyPostpartumKenyan woman
(n = 572)		Kenya2022Mobile app; SMS/text (mobile WACh NEO, two-way SMS communication intervention)EPDSPD (32.9%), postnatal depression (9.1%)
Women with PD sent fewer SMS messages to health providers, indicating lower engagement with mHealth interventions
mHealth intervention could provide more tailored messages to women with depressive symptoms to provide better individual support and psychoeducational messages
[28]Randomized controlled trialPostpartumAsian (Chinese)
(n = 168)		China2018–2020Mobile appEPDS, PHQ-9Participants had 2.471 times higher odds of a decreased EPDS score from baseline to post intervention in comparison to the control group
Cost-effective approach to address mental health issues during pregnancy when resources are limited
Smartphone-based mindfulness training tailored for pregnant women has a substantial effect
[29]Pilot studyPerinatal (broad)—United States2022Mobile app—Effectively reduce the incidence of PD by incorporating brief, scalable interventions within standard prenatal care
Hybrid digital and synchronous approach facilitates flexible participation for diverse populations, systemic barriers such as geographic, socioeconomic, and cultural challenges
[30]Longitudinal studyPostpartumAsian (Chinese)
(n = 150,000)		China2021Mobile appEPDSSuccessful integration of the mHealth app increased referral success rates for PPD over time
Health resource allocation and well-informed management systems showed greater improvements, indicating that effective implementation can strengthen health-seeking behaviors among postpartum women in Asian contexts
[31]Qualitative studyPostpartumNon-indigenous Canadian (Chinese-6, South Asian-3)Canada2021Mobile app (web-enabled intervention)EPDSProvided information on daily prompts/check-ins, mental health tracking, and self-care information, resources for holistic care
Value of connecting to peers and professionals through web-enabled tools, emphasized importance in mental health journeys: “I think just some way of encouraging women whether it be through success stories or a connection with a counsellor, whatever it is, through the app that, um, would just encourage them not to give up and encourage them that it will get better”
Future research project to assess the needs of indigenous women and immigrant women who have experienced PPD, representing and understanding the diverse needs of Canadian women
[32]Randomized controlled trialPostpartumAsian (Chinese)
(n = 130)		China2022Mobile appEPDSA significant decrease in the level of postpartum depressive symptoms among the women who mobile app
Incorporation of culturally sensitive features, such as social support, parenting education in app, to tailor the app to meet the needs of Asian American women
[33]Review studyPostpartumAsian (Chinese)Chinese2019Mobile appEPDSExisting PPD apps lacked adherence to clinical practice guidelines, comprehensive content, and high user engagement
Content of the Chinese clinical practice guidelines, significant for improvised app based on the existing ones
[34]Observational studyPostpartumRural veteran women (2.4% Asian)United States2015–2019Mobile appPHQ-9Decreased depressive symptoms, increased behavioral activation, and decreased dysfunctional automatic thoughts
Program and coaches were positively rated, though urban women tended to rate coaches more highly, and rural women spent less time per call with their coaches
High reach and broad demographic diversity, scalability, and relevance across various racial and ethnic groups
[35]Systematic reviewPostpartumDiverse backgroundCanada2018Mobile app; SMS/textEPDSmHealth interventions targeting mental health were found to reduce PPD compared to no intervention
Evidence insufficient to draw firm conclusions about their impact on other psychosocial outcomes, such as self-efficacy, social support, and postpartum anxiety, due to mixed findings, small sample sizes, and heterogeneity in intervention type
[36]Protocol-randomized controlled trialPostpartumAsian (Chinese)
(n = 120)		China2019Mobile appEPDSMobile phone app based CBT on PPD focuses on addressing the shortage and health disparities of mental health resources, stigma of PPD in postpartum women, and the need for postpartum recovery and child care prevents postpartum women from seeking traditional face-to-face CBT
Outcome measures include PPD, anxiety, pressure, and parenting sense of competence at 0, 3, and 6 months after the intervention
[37]Qualitative studyPostpartumWhite/Caucasian, African American/Black
(n = 24)		Online social support group2017Mobile app (online support group)—Online support groups provide a need to communicate to end their sense of isolation. “It was very isolating with my first because I didn’t have any friends who had kids yet. I was the first of my friends to have kids, so I did join a bunch of mom groups on Facebook”
Provides a platform to fulfill the desire to gather information from experienced people. “Never really anyone professional, but it’s helpful to hear real people’s experiences”
Online social support developed the motivation to reciprocate, “I was able to get support because other people posted that had the same experience... that’s the whole point to be able to share your information so other people can better stay informed about it”
Some women lacked motivation to be online, did not have the time and energy to participate (due to underlying PPD symptoms), sharing personal stories with unknown people didn’t feel reliable, and felt inadequate or self-criticism
[38]Systematic reviewPostpartumDiverse backgroundDiverse geography2021Mobile appEPDS, Beck Anxiety Inventory,
Center for Epidemiologic Studies Depression Scale 		mHealth interventions had a positive effect on social support from partners and healthcare providers
Socially disadvantaged pregnant women and mothers with pre-existing health conditions and behaviors, sensitive perinatal issues benefited
mHealth interventions enabled users with tailored needs to their preferences (e.g., cultural, literacy, language preferences)
[39]Mixed-method studyPostpartumUnited States populationUnited States2021Mobile app; SMS/textEPDSMama Lift Plus digital app acceptable, usable, and feasible for new mothers to address symptoms associated with PPD
Suggestion to engage with a healthcare provider via the app at least weekly
Text messaging preferred mode of communication
[40]Randomized controlled trialPostpartumNon-White (included Black, Chinese, Filipino, Latin American, Greek, and Indigenous)
(n = 171)		Canada2021SMS/textEPDSPostpartum text message program effectively improved maternal self-efficacy, especially among first-time mothers (primiparous women)
Reduced postpartum anxiety symptoms in both primiparous and multiparous women six weeks postpartum
No significant changes in PPD or perceived social support scores
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EPDS: Edinburgh Postnatal Depression Scale; iCBT: internet-based cognitive behavioral therapy; ISI: Insomnia Severity Index; mHealth: mobile health; PD: perinatal depression; PHQ: Patient Health Questionnaire; PPD: postpartum depression.